Couldn’t I have had the bad news first?

IT’s currently 2am and it seems like sleep is not something I’m going to be getting for a while so I might as well do something somewhat useful and document my day while I have the words in my head and the time on my hands.

Today was Complex Cases Team appointment meeting. Dare I hope that the NHS would actually function with regards to mental health? That there would be help out there for me and that life isn’t just one long wait for a solution that’s never going to happen. On the way out the door, noticed that the post had been delivered including one of those ominous brown envelopes that always look like they’re going to contain important news, almost invariably bad. Paused to open it, expecting yet another problem that I’d have to deal with (or more probably file under floor until the letters become slightly more threatening). Instead it was my DLA award letter. They’re actually going to pay me and at a rate higher than I’d even let myself imagine I’d get. I’ve no doubt this is entirely down to how CAB lady worded the form for me. Someone will be getting a large box of chocolates next time I see her! Understandably this news left me somewhat buoyed up as I headed to the appointment. Money will now be a small amount less of a worry and I will hopefully feel somewhat less guilty after my next trip to the supermarket again lands me with a basket full of expensive randomness (aka the only things I felt like eating at that particular time).

Arrived slightly early for appointment. Made myself known to receptionist who looked at me with thinly veiled distrust when I forgot the name of the doctor I was there to see. I suppose it was in the grounds of the mental health hospital and I could have been a random patient attempting to score some bonus therapy but it does seem unlikely. Sat and shook in standard NHS waiting room. Stared at the leaflets – an introduction to depression, dementia, schizophrenia – you name it they have a leaflet for it promising a wide range of solutions which bitter experience suggests they will fail to provide.

Eventually the doctor arrives and looks me up and down with vague disinterest. I start to wonder if the receptionist had mentioned that I forgot her name. We head off to the consultation room. She’s wearing a long denim skirt that’s too tight to allow her to take proper steps. For some reason I find this intensely irritating.

I’ve attempted to recount the conversation. The italics in my sections are what I was thinking and the rest is roughly what I/she said.

Right, we have 50mins for me to form an opinion of you. So, why are you here?

Initially words fail me and I trip over them in my nervousness. Trying to form a vaguely coherent sentence seems temporarily beyond me never mind a concise and meaningful summary of the current point my life had reached. Besides, I had been kind of hoping she could tell me that. I’m somewhat hazy as to the purpose of a COmplex Cases Team, not that the appointment cleared any of that up…

Tell me what’s happened recently.

How recent is recent? When everything seems so interlinked, how can you possibly begin in the middle? I explain that things are complicated, I’m complicated but eventually settle for January and dropping out of nursing as a suitable point to begin. I try to keep it concise but realise I’m babbling, missing key details.

Can you give me a brief summary of your life.

Brief, you’ve got it. 30 seconds later and I’m done.

Hmm, I was hoping for somewhat more detail. Let’s start with your childhood.

Well, I was born in X and lived there until I was five. Then we moved to Y and I started to school.

How did you feel?

Funnily enough, I can’t remember, I was 5. For fucks sake, I struggle to remember how I felt half an hour ago and you’re asking me to recall things from almost 20 years ago.

OK, let’s move on. Where did you go from there?

I continue with occasional interjections requesting an account of my feelings at any major points of change. She keeps going on about first relationships and looks faintly horrified when I say I wasn’t in one until I was 19. As if this was  my major failing. If I’d fallen in love age 10, maybe things would have been different?! Eventually we get to times recent enough that I can finally start to recall “feelings”. I talk and put across what in my mind seems to be the correct view of events while I was studying for my A-levels.

Let’s move on to University.

I start to describe my first year, back when things were still going ok. When I had friends who seemed to really care, back when I wanted this whole life thing. I talk about meeting my boyfriend, falling madly in love and then things starting to go more than a little wrong during my second year. Starting to break down.

So this is the first time you started to have bad thoughts?

I think a bit deeper and recall the journals stashed in the attic at home. I had them before, during my A-levels.

No, you said your A-levels were happy. Why have you changed the story?

I’ve remembered what I wrote when they were going on. A racing mind and the start of suicidal thoughts that came and went.  This is the problem with questions about how I felt in the past. I’ll recount whatever basic whitewash my mind has put over events in an attempt to protect me from memories I don’t want to face. It’s only when I force myself to look beyond that, that an approximation of the truth starts to emerge.

Let’s continue…

I talk about the rest of university, moving to York and returning again. The end of my relationship and the pain that caused which hasn’t even begun to heal. My oder of events around here gets somewhat hazy at times and it gets confusing when I attempt to explain which job/psychiatrist/experience I’m currently describing.

OK, we’re out of time. What would you like to get from this?

Help, I want this to stop. I want to get some direction, to be able to hold down a job. To gain some level of normality. basically, I want some form of psychotherapy please.

Well, we don’t focus on that here. We’re more interested in self-harm and stopping that. Would you be interested in this?

WTF? Where the hell did that come from? Obviously we’d talked about SH in the ‘history taking’ and the fact it’s an almost daily occurrence right about now but that’s not the focus of my concern as much as I hate myself for it. I want to tackle the underlying problems. I reckon if we can get to the route of what’s going on, I won’t need the maladaptive coping mechanisms and so they  would take care of themselves. I know I could stop self-harming if I was given a good reason. That’s not what I need help with. Yes, I suppose so but…

Well, we’ve gone well over time here. I’ll be in contact within 7-10 days to let you know what we’ve decided and if there’s anything we can offer

So all in all I don’t feel complex cases are going to be much help for me. It’s just made everything raw again. This is a right bugger because I was holding on while I was starting to see things move in the right direction and if things aren’t going to move, then I don’t see much point in holding on for that much longer.

Also, it concerns me that the doctor took no notes at all during the consultation. IS she seriously going to remember everything I said in over an hour of talking? And if not, what was the point in all those questions? I’m now paranoid she was recording it without my permission and I find this deeply, deeply disturbing.

It’s now 0330 and I really should try to sleep. It’s the done thing doncha know?!

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4 Responses to Couldn’t I have had the bad news first?

  1. Bippidee says:

    Oh dear, sounds like Complex Cases were shit. I shouldn’t be suprised really. Fairly typical that the BPD service is only interested in stopping self harming, because then everything will be ok of course. I am not really a fan of behavioural approaches I suppose. As you said, coping mechanisms are just that, and in my experience stopping one just means starting another (purging for self harming for restricting etc etc). Good news about the DLA though! x

  2. Alison says:

    I’m glad you got the DLA through, pleased for you on that one! 🙂

  3. Nurse Converse says:

    Yay for DLA! Boo for sh!t therapist. I know it’s horrid and demoralising and exhausting but if you do want psychotherapy then you sometimes have to look around for a good therapist. Some are AWFUL but there are good ones out there.

    Bippidee is right, ther’s no point just magically getting rid of SH, what are you going to be left with then? You need someone who can help you understand why. xx

  4. aims says:

    I was wondering – since living in another country – if they would perhaps help with the why when they give you the help on the SH. Is that a possibility? Anybody else gone through what Ana has talked about here? What is involved and what is done? Did she say?

    Sorry I’m not much help on this but I would think that they’d have to look into the why when they try to help. That seems logical to me.

    I doubt she recorded you thought Ana. I think she was just a bitch. She sure sounded like one.

    And just so you don’t feel like you’re the only one – I do exactly the same thing when I’m standing in the headlights. I get brain freeze and everything is confused in my brain. I sometimes never remember the proper order but sometimes I do later and feel like a true idiot. But I think we’re just normal – for us.

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